Periodontology 2000最新文献

{"title":"The use of pain scales in scientific studies on dentin hypersensitivity: A scoping study.","authors":"C Gupta,M Barber,F Boissonade,N Flannigan,N Wong,B J Gibson","doi":"10.1111/prd.70043","DOIUrl":"https://doi.org/10.1111/prd.70043","url":null,"abstract":"OBJECTIVEThis scoping review aimed to identify the pain scales used to clinically evaluate dentin hypersensitivity (DH) in existing literature and the references provided for their selection.METHODSThe scoping review followed the PRISMA and JBI guidelines. An electronic search of the literature was conducted across Web of Science, PubMed (Medline), Scopus, and CINAHL. Eligible studies included adult participants with DH who were assessed using pain scales. After screening, data were extracted and synthesised to identify the most commonly used pain scales and the theoretical and methodological justification for their use.RESULTSSeventy-one studies were included in the review, and most of them were randomised studies (randomised clinical studies + RCTs = 81.7%). The visual analog scale (VAS) was the most frequently used pain measurement, followed by the Schiff Cold Air Sensitivity scale (SCASS). Use of both scales together was also identified as a common practice. There were inconsistencies in the references provided as the rationale for the use of the pain measurement tools.CONCLUSIONSVAS and SCASS are unidimensional scales that are used in DH research without an adequate theoretical understanding of the condition and methodological considerations. More research needs to be conducted on the methodological suitability of the pain scales and the conceptual understanding of pain management in DH.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"3 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An integrated behavioral change model for smoking cessation in periodontal care: The four‐stage behavioral support staircase","authors":"Christoph A. Ramseier","doi":"10.1111/prd.70040","DOIUrl":"https://doi.org/10.1111/prd.70040","url":null,"abstract":"Objectives Smoking tobacco is a critical modifiable risk factor for periodontal and peri‐implant diseases. This narrative review integrates established behavioral theories with communication‐based psychological processes to propose an evidence‐based model for smoking cessation support in periodontal care. While the model is developed around smoking cessation, its underlying principles are applicable to broader behavioral risk factor management in dental practice. Materials and Methods Evidence from systematic reviews, randomized controlled trials, and international guidelines was synthesized to determine effective strategies. Key concepts analyzed include the transtheoretical model (TTM), the COM‐B model and motivational interviewing (MI), and the impact of personalized risk communication and biofeedback on patient adherence. Results Structured behavioral interventions, particularly in combination with pharmacotherapy and personalized feedback (e.g., risk scores or biomarker testing), improve quit rates and, consequently, periodontal outcomes. The proposed four‐stage behavioral support staircase provides a clinical support structure comprising connection (rapport), information, motivation and action, with continuous evaluation. Complementing this is an “elemental” metaphor to guide clinicians through patient resistance, ambivalence, and the emotional adaptation inherent in cessation. Conclusions Smoking cessation serves as a model for how structured behavioral support can be integrated into periodontal therapy. The presented frameworks provide oral health professionals with guidance on the complex cognitive, emotional, and motivational transitions necessary for achieving long‐term periodontal stability. Clinical Relevance This educational model enables periodontal teams to systematically address modifiable behavioral risk factors. It offers a four‐stage approach to supporting cessation and managing relapse, shifting the focus from didactic instruction to a patient‐centered collaborative approach.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"18 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of neutrophils in the pathophysiology of inflammatory bowel diseases","authors":"Joao Paulo Steffens, Ekin Yay‐Kus, Rafael Scaf de Molon, Viorelia Stoica, Peter Rimmer, Josefine Hirschfeld, Asif Jilani Iqbal, Tariq Iqbal, Iain Chapple","doi":"10.1111/prd.70037","DOIUrl":"https://doi.org/10.1111/prd.70037","url":null,"abstract":"Objectives Inflammatory bowel disease (IBD) encompasses a spectrum of chronic disorders of the gastrointestinal tract, with a potential bidirectional relationship with periodontitis. Neutrophils are key regulators of immune‐inflammatory responses and play a major role in both diseases. Isolating and characterizing gut lumen neutrophils may help to map the evolution of cell phenotypes from peripheral blood to saliva and help explain certain mechanistic relationships within the oral‐gut axis. This review aims to critically evaluate the biological sources of human neutrophils and the emerging analytical approaches to their study in IBD. Materials and Methods Studies employing various methodological strategies to isolate and analyze neutrophils derived from both systemic (peripheral blood) and mucosal compartments in IBD are synthesized. Data obtained through different analytical modalities are discussed. Results Neutrophils play multifaceted roles in IBD beyond their traditional function in pathogen clearance and acute inflammation. They contribute to both tissue injury and repair through the release of proteolytic enzymes, reactive oxygen species, cytokines, and neutrophil extracellular traps. Recent advances in analytical technologies have uncovered remarkable phenotypic and functional diversity, shaped by the local microenvironment within the intestinal mucosa. Conclusions Neutrophils' ability to both exacerbate mucosal damage and facilitate resolution of inflammation underscores the need for improved methodological approaches that enable precise characterization of their functional states in both systemic and tissue contexts. Clinical Relevance Improved phenotypic and functional profiling of neutrophils may facilitate the identification of biomarkers predictive of disease activity, treatment response, and relapse risk, and contribute to the understanding of the role of neutrophils in the interplay between IBD and periodontitis.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"20 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone biology in aging periodontal and peri‐implant tissues","authors":"Dalia Rasheed Issa, Giuseppe Intini, Daniel Clark","doi":"10.1111/prd.70035","DOIUrl":"https://doi.org/10.1111/prd.70035","url":null,"abstract":"Background Periodontal disease is an age‐related chronic inflammatory condition leading to tooth loss. Dental implants are an option for replacement of lost teeth in older adults. However, age‐related changes to alveolar bone may have pathological implications for its role in supporting the dentition and dental implants. Aim This narrative review will focus on the age‐related changes that affect alveolar bone and the implications for periodontal disease and implant dentistry. Materials and Methods A literature search using the PubMed database was conducted. Search terms focused on the known age‐related pathological process affecting bone and involved in peri‐implant and periodontal disease. Conclusion The literature demonstrates the multi‐faceted physiological changes that affect alveolar bone as a function of increased age. Osteoporosis is a commonly recognized feature of aging and studies support its association with periodontal disease as well as the growing body of work demonstrating the effects of osteoporosis on dental implant success. Furthermore, age‐related cellular perturbations have a detrimental impact on the strict inflammatory regulation that is required for bone homeostasis and during healing and regenerative processes. Finally, age‐related changes to osteoprogenitor cells likely contribute to pathology in the alveolar bone. However, multiple therapeutic targets have been identified to alter osteoprogenitor cell function for improvement of bone regeneration and homeostasis. Clinical Relevance Pathological changes that occur with age can be detrimental to alveolar bone, and an improved understanding of such changes can translate to future treatment modalities for the enhanced management of periodontal disease and dental implants in older adults.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"35 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long‐term periodontal and peri‐implant tissue stability under supportive therapy","authors":"Hom‐Lay Wang, Javier Calatrava, Maria Costanza Soldini, Javi Vilarrasa, Anton Sculean, Alberto Monje","doi":"10.1111/prd.70038","DOIUrl":"https://doi.org/10.1111/prd.70038","url":null,"abstract":"Background Supportive periodontal and peri‐implant maintenance therapy is strongly associated with improved long‐term retention and stability of natural teeth and dental implants. Lack of regular professional follow‐up after initial therapy is a major risk factor for disease recurrence and tooth or implant loss. Despite well‐established benefits, patient compliance with maintenance regimens remains suboptimal, and the ideal protocols and intervals for sustained tissue health are under debate, Aim This review aimed to synthesize current evidence regarding the impact of supportive therapy on long‐term periodontal and peri‐implant tissue stability, including optimal maintenance intervals, protocols, risk profiles, and emerging technologies for personalized care. Material and Methods A comprehensive literature review was conducted using PubMed, Embase, and Scopus databases, focusing on longitudinal and cohort studies, randomized controlled trials, systematic reviews, and recent consensus guidelines addressing the effects of supportive therapy on periodontal and peri‐implant outcomes. Data on maintenance intervals, clinical protocols, risk assessment tools, recurrence after nonsurgical and surgical therapies, and adjunctive innovations (AI, imaging, biomarker testing) were collated and critically appraised. Results Long‐term studies consistently demonstrate that regular supportive periodontal care (SPC) and supportive peri‐implant care (SPIC) markedly reduce rates of tooth and implant loss, progression of periodontitis and peri‐implantitis, and minimize the need for complex surgical re‐interventions. Frequent recalls—every 3–6 months for moderate‐ to high‐risk patients and up to 12 months for low‐risk—result in significantly better outcomes. Protocols incorporating individualized risk assessment (e.g., Personalized Risk Assessment (PRA) and Implant Disease Risk Assessment (IDRA) algorithms), thorough mechanical biofilm removal, personalized oral hygiene instructions, and modification of risk factors enhance tissue stability. Non‐compliance and residual pockets (≥5–6 mm) are major predictors of recurrence. While both conventional and emerging biofilm control methods (ultrasonic scaling, air‐polishing, guided biofilm therapy) are effective, no single protocol shows superior long‐term results. Recent advances in chair‐side biomarker testing and AI‐supported image analysis offer promising tools for early detection and proactive management of at‐risk patients. Although early data are encouraging, the clinical integration of these technologies remains largely guided by expert interpretation pending long‐term outcome validation. Conclusions Consistent adherence to structured supportive therapy protocols following active periodontal or implant interventions is essential for the long‐term health and stability of periodontal and peri‐implant tissues. Maintenance intervals and protocols should be individualized based on patient, site, and prosthetic risk profile","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"25 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not a miracle, not a myth: The role of probiotics in periodontal health","authors":"Teughels Wim, Saghi Mehraveh, Lauwens Katalina, Chia Wei Cheah, Pittayapat Pisha, Castro Ana, Temmerman Andy, Zayed Naiera, Van Holm Wannes","doi":"10.1111/prd.70039","DOIUrl":"https://doi.org/10.1111/prd.70039","url":null,"abstract":"Background As the understanding of periodontal disease has evolved, therapeutic strategies have increasingly shifted from pathogen eradication toward ecological modulation of the oral microbiome. Within this paradigm, probiotics have emerged as potential adjuncts for maintaining periodontal health by promoting microbial balance and modulating host responses. Objective To summarize the historical development, definitions, and mechanisms of probiotics and to critically evaluate the current clinical evidence supporting their use in periodontal therapy. Methods This narrative review examines the conceptual framework of probiotics in oral health, distinguishing them from related approaches including prebiotics, postbiotics, and synbiotics. Literature from randomized controlled trials and meta‐analyses was reviewed to assess the clinical effectiveness of probiotic interventions in periodontal therapy and to explore their proposed mechanisms of action. Results Probiotic effects are highly strain‐specific and involve multiple mechanisms, including production of antimicrobial compounds, competition for ecological niches, inhibition of biofilm formation and quorum sensing, strengthening of epithelial barrier integrity, and modulation of host immune and inflammatory responses. Evidence from randomized controlled trials and meta‐analyses, particularly those evaluating <jats:italic>Limosilactobacillus reuteri</jats:italic> strains, suggests that probiotics used as adjuncts to nonsurgical periodontal therapy can significantly improve clinical parameters such as probing pocket depth, clinical attachment level, and bleeding on probing. However, substantial heterogeneity in study design, probiotic strains, delivery systems, and follow‐up periods limits the comparability and generalizability of findings. Conclusions Probiotics represent a biologically plausible and ecologically oriented adjunct in periodontal therapy. While current evidence indicates beneficial clinical effects, further standardized and long‐term clinical trials incorporating advanced microbiome analyses (e.g., next‐generation sequencing) are needed to clarify mechanisms, optimize formulations, and support personalized probiotic strategies in periodontal care.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"131 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147636056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact and efficacy of systemic antibiotics for peri-implant diseases treatment: A systematic review and meta-analysis on clinical and microbiological outcomes.","authors":"Gaetano Isola,Alessandro Polizzi,Angela Angjelova,Elena Jovanova,Giuseppe Pizzo,Anton Sculean","doi":"10.1111/prd.70033","DOIUrl":"https://doi.org/10.1111/prd.70033","url":null,"abstract":"AIMTo evaluate the adjunctive effects of systemic antibiotics (SA) on clinical and microbiological outcomes in the treatment of peri-implant diseases.MATERIALS AND METHODSA systematic review and meta-analysis were conducted following PRISMA guidelines and registered on PROSPERO (CRD420251059056). Randomized and non-randomized clinical trials evaluating SA as adjuncts to non-surgical treatment of peri-implant mucositis (PM) and to non-surgical or surgical therapy of peri-implantitis (PI) were included. Rob2 and MINORS tools were used to assess the risk of bias of included articles.RESULTSEighteen studies were included in the qualitative analysis, of which only nine randomized clinical trials met the criteria for quantitative analysis. For PM treatment, SA did not significantly affect any assessed clinical outcomes (p>0.05). For PI treatment, the meta-analysis showed that, in both non-surgical and surgical PI treatment, adjunctive SA resulted in a significant bleeding on probing reduction at 12 months (p=0.007) and a significant probing pocket depth reduction at 12 months (p=0.004). However, no significant improvements in marginal bone level (MBL) were observed. For antimicrobial outcomes, only 2 studies reported significant effects of metronidazole as an adjunct to treatment on reductions in P. gingivalis and T. forsythia up to 12 months.CONCLUSIONSSA do not provide additional clinical or microbiological benefits in the treatment of PM. In PI, adjunctive systemic antibiotics may offer only limited improvements in selected clinical outcomes and specific peri-implant pathogens for up to 12 months, without consistent benefits on MBL. However, given the heterogeneity of the available evidence, further high-quality, long-term studies are needed.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"31 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147585571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long‐term outcomes of lateral sinus floor elevation: A machine‐learning analysis, systematic review, and meta‐analysis of predictive factors","authors":"Hamoun Sabri, Muhammad H. A. Saleh, Paolo Nava, Riccardo Scaini, Tiziano Testori, Massimo Del Fabbro","doi":"10.1111/prd.70028","DOIUrl":"https://doi.org/10.1111/prd.70028","url":null,"abstract":"Objectives To quantify long‐term (≥ 5 years) implant survival after lateral sinus floor elevation (LSFE) and to identify clinical predictors of long‐term survival using conventional and machine‐learning meta‐analytic techniques. Methods A systematic search was conducted through MEDLINE, Embase and Scopus. Randomized trials, prospective or retrospective studies with ≥ 10 patients and ≥ 5‐year follow‐up were eligible. Risk of bias was assessed with RoB‐2 (RCTs) and the Newcastle–Ottawa Scale (observational studies); certainty of evidence was graded with GRADE approach. A multilevel random‐effects meta‐analysis (logit‐transformed proportions) estimated pooled survival while accounting for clustering of multiple implants per patient. Moderator effects were explored by mixed‐effects meta‐regression. A MetaForest machine‐learning model examined non‐linear interactions among predictive factors. Results Thirty‐two studies (48 cohorts) involving 7,902 implants and ≈ 2,800 patients met the criteria (3 RCTs, 7 prospective non‐randomized, and 22 retrospective studies; follow‐up 5–13 years). Pooled long‐term survival was 95.8 % (95 % CI: 94.5–96.8 %); Heterogeneity was substantial (I² = 82.8 %) but fell to 53.2 % in MetaForest residuals. Meta‐regression identified lower survival with Graftless procedures versus allografts(β = 1.11, p = 0.016), autografts(β =2.40, p = 0.005), Xenografts(β =1.53, p = 0.04), Xenografts+Allografts(β =1.55, p = 0.04) and Xenografts+Autografts(β =1.82, p = 0.03) with no significant difference versus Alloplasts. Residual bone height (RBH) &lt; 4 mm (β = –0.53, p = 0.039) as well as smoking prevalence (1.96 % per 10 % increase, p = 0.009) reduced survival. MetaForest ranked smoking, age, RBH, follow‐up duration and membrane use as the principal predictors; barrier membranes mitigated the negative effect in smokers and in low‐RBH sites. Time‐to‐failure analysis of 205 failed implants showed 59 % of losses within the first year and 96 % by year 5. Overall certainty of evidence was low. Conclusions Implants placed after LSFE exhibit high 5–13‐year survival (96 %). Use of bone graft materials and their mixtures yield more favorable outcomes compared to Graftless protocol, whereas RBH &lt; 4 mm and smoking significantly impair implant survival. Barrier‐membrane coverage is advisable for smokers and short‐RBH sites. Despite the long‐term nature of this review (≥5 years of follow‐up), most failures occur within the first three years of function, underscoring the need for intensified monitoring during this early phase.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"272 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147507922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral wound healing in the elderly: Mechanisms, challenges, and innovations","authors":"Ann M. Decker, Sandra H. Stuhr, Gustavo Avila‐Ortiz, Andrea Pilloni, Lorenzo Marini, Rogerio Castilho, Beth I. Wallace, Yvonne L. Hernandez‐Kapila","doi":"10.1111/prd.70027","DOIUrl":"https://doi.org/10.1111/prd.70027","url":null,"abstract":"Objective This narrative synthesizes current knowledge on the biological mechanisms, clinical challenges, and regenerative innovations for optimizing intraoral wound healing in the elderly. Methods Narrative review of preclinical and clinical studies addressing age‐related changes in the four canonical wound‐healing phases (hemostasis, inflammation, proliferation, remodeling), tissue‐specific molecular pathways, systemic and local factors affecting repair, operative considerations, and emerging therapeutic modalities. Data sources included PubMed, Embase, and Cochrane databases through June 2025. Results Aging compromises each repair phase. Hemostasis is prolonged by diminished platelet function and altered clot architecture. Inflammation is exacerbated by impaired neutrophil/phagocyte activity and persistent reactive oxygen species. Proliferation is slowed by reduced fibroblast proliferation and angiogenic signaling, while dysregulated matrix metalloproteinase activity impairs extracellular matrix remodeling. Tissue‐specific cues in oral mucosa, periodontal ligament, cementum, and bone are also altered with age. Compounding factors—including “inflamm‐aging,” malnutrition, polypharmacy‐induced xerostomia, cognitive decline, and frailty—further impede healing. Clinical optimization requires comprehensive preoperative risk and frailty assessments; medical/nutritional management; minimally invasive flap designs; tension‐free primary closure; streamlined surgical protocols to limit operative time; and postoperative monitoring with tailored communication. Emerging regenerative strategies—growth factors (PDGF, FGF), platelet concentrates, gene and cell‐based approaches (MSCs, exosomes), immunomodulatory scaffolds/agents, photobiomodulation, and AI‐driven risk dashboards—show promise for enhancing repair in aging populations. Conclusions Effective oral wound healing in older adults demands a multidisciplinary, personalized approach that integrates meticulous perioperative care with novel regenerative modalities. Standardization and clinical validation of emerging therapies are essential to translate biological insights into improved patient outcomes.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"18 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147507927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long‐term stability after nonsurgical treatment of periodontitis","authors":"Ignacio Sanz Sánchez, Maria Clotilde Carra, Ana Carrillo de Albornoz, Mario Romandini, Eduardo Montero, Mariano Sanz","doi":"10.1111/prd.70032","DOIUrl":"https://doi.org/10.1111/prd.70032","url":null,"abstract":"Background Non‐surgical periodontal therapy (NSPT) remains the fundamental approach in periodontal treatment and has been extensively studied over the past decades. Evidence consistently shows that NSPT exerts a substantial and sustained impact on tooth retention and on key surrogate outcomes, including gains in clinical attachment levels, reductions in probing pocket depths and improvements in inflammatory parameters. Aim To evaluate the long‐term (≥5 years) efficacy of non‐surgical periodontal therapy and to explore the effect of alternative or adjunctive mechanical methods (e.g., laser, air‐polishing devices, etc.) compared to hand, sonic, or ultrasonic instruments in NSPT. Material and Methods A systematic electronic search was conducted to analyse the scientific literature available by including all potential studies reporting long‐term results of the non‐surgical periodontal treatment, regardless of study design. To evaluate the effectiveness of alternative protocols for subgingival instrumentation, a systematic electronic sear was also conducted including only randomized clinical trials (RCTs). Results 27 manuscripts corresponding to 20 investigations reported on the long‐term outcomes of non‐surgical therapy. Most of the studies showed low incidence of tooth loss, clinical attachment gains at initially deep pockets and probing pocket depth reductions, especially on those patients attending regularly supportive periodontal care (SPC). The use of laser as an alternative to hand instruments or ultrasonic devices, or as adjuncts to subgingival instrumentation has shown conflictive results. Some studies evaluating the adjunctive use of antimicrobial photodynamic therapy have reported modest clinical improvements in the short term (3 to 6 months). Subgingival air‐polishing may offer potential benefits for patient comfort and shorter treatment times. Conclusions Overall, the available evidence supports NSPT as a reliable and long‐lasting treatment option, while emphasizing the need for further research on patient reported outcomes and systemic effects within the long‐term framework of comprehensive periodontal treatment. Clinical Relevance Non‐surgical periodontal therapy is the key tool for treating periodontitis in most patients. The gold standard treatment is subgingival instrumentation using hand‐ or power‐driven instruments, together with regular SPC. Various alternative or adjunctive therapies have been suggested, but the evidence available is limited, particularly in the long term.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"8 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147507924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}